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Blue Shield of California · 7 hours ago

Director, Systems Solutioning & Configuration

California, United States

Full-time

Hybrid

Director/Executive

15+ years exp

Blue Shield of California is seeking a Director of Solutioning & Configuration who will provide strategic leadership for Facets solution design and operational scalability. The role involves overseeing solution architecture, governance processes, and driving improvements through automation and AI-enabled tools to support enterprise growth.

Financial ServicesHealth InsuranceNon Profit

H1B Sponsor Likely

Responsibilities

Provide strategic oversight of Facets solution architecture and ensure all configuration, design approaches align with enterprise priorities, modernization goals, and compliance standards. Establish architecture principles and decision framework that guide scalable solutions across all business domains

Define, implement, and enforce governance process for configuration standards, reusable patterns, and design quality controls. Establish structured checkpoints to ensure consistent, traceability, and quality across all system changes

Recruit, develop, and lead a high-performing team of Facets subject matter experts. Build structured learning pathways and certification programs that elevate internal capabilities and reduce reliance on vendors for solutioning and configuration work

Create and maintain comprehensive knowledge repositories, reusable configuration assets, and standardized templates. Promote organizational learning through documentation, playbooks, and implementation guides that accelerate delivery across programs

Oversee the solutioning and configuration lifecycle for new healthcare products, market expansions, customer onboarding, and employer group setup. Ensure delivery is timely, accurate, compliant, and aligned with operational readiness requirements

Drive the adoption of AI enabled tools and automation capabilities to accelerate configuration, reduce manual effort, and improve accuracy. Elevate and implement AI models for rules analysis, configuration recommendations, defects pattern detection, and test automation

Lead operational excellence initiatives that streamline solutioning, configuration, and cross-functional processes. Identify bottlenecks and execute improvements that enhance throughput, reduce rework, and improve overall delivery quality

Identify opportunities to improve system performance, claims processing accuracy, and auto-adjudication through optimized Facets configuration. Ensure that configuration decision support scalability, reliability, and cost-effective operations

Serve as the primary liaison to business, IT, operations, and vendor partners to ensure alignment on solution strategies, configuration impacts, delivery timeline, and value realization. Promote transparency and strategic clarity across all stakeholder groups

Lead change management efforts to introduce new standards, configuration models, and delivery processes. Ensure teams understand impacts, adopt new practices, and effectively operationalize new capabilities

Qualification

Facets solutioningSolution architectureHealth care payer systemsAutomation toolsAI-enabled toolsStakeholder managementInnovation mindsetLeadershipCommunication skills

Required

Bachelor's degree or four years diploma in Information Systems, Healthcare Administration, Business, or related field

15+ years of progressive experience in health care payer systems, with deep expertise in Facets solutioning and configuration

Proven leadership experience building and managing high performing solution architecture and configuration teams

Strong understanding of core health plan operations, including enrollment, benefits, claims, billing, provider, and utilization management

Experience supporting multiple lines of businesses, including Commercial, Medicare, and Medicaid

Hands-on experience establishing solution governance, design standards, and configuration quality controls

Experience leveraging automation and AI-enabled tools to improve configuration accuracy, speed, and quality

Strong financial acumen with demonstrated ability to manage and reduce delivery costs

Excellent communication skills with the ability to translate complex technical solutions into clear business insights

Proven change leadership and stakeholder management skills across business, IT, and operations

Innovation mindset is critical

Company

Blue Shield of California

Glassdoor3.8

Blue Shield of California is a health insurance service provider.

Founded in 1939

San Francisco, California, USA

5001-10000 employees

https://www.blueshieldca.com

H1B Sponsorship

Blue Shield of California has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (1)

2022 (41)

2021 (20)

2020 (31)